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Peritoneal dialysis patient selection from a comorbidity perspective.

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Peritoneal dialysis (PD) is underutilized despite benefits. This review explores overcoming perceived medical barriers to increase PD use in kidney patients.

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Area of Science:

  • Nephrology
  • Renal Replacement Therapy

Background:

  • Peritoneal dialysis (PD) offers advantages but remains underutilized, with 5%-20% of patients using it compared to hemodialysis.
  • Barriers include lack of experience, infrastructure, economic incentives, and perceived medical contraindications.
  • Conditions like advanced age, diabetes, obesity, heart failure, and prior abdominal surgery are often wrongly seen as contraindications.

Purpose of the Study:

  • To review the factors hindering peritoneal dialysis (PD) adoption.
  • To discuss how perceived medical contraindications influence PD patient selection.
  • To identify strategies for overcoming these barriers and expanding PD use.

Main Methods:

  • Literature review of factors affecting PD utilization.
  • Analysis of perceived contraindications for PD initiation.
  • Discussion of management strategies for PD patients with comorbidities.

Main Results:

  • Peritoneal dialysis (PD) is underused due to systemic and patient-specific barriers.
  • Many medical conditions are wrongly considered contraindications, limiting PD access.
  • Strategies exist to manage patients with comorbidities on PD.

Conclusions:

  • Addressing perceived contraindications and improving infrastructure can increase PD utilization.
  • Optimizing patient selection and management strategies are key to expanding PD.
  • Overcoming barriers is crucial for leveraging the benefits of PD in chronic kidney disease management.